A GROWING PROBLEM AMONG CHILDREN
RHCI Adds Services For Speech & Feeding Problems

The mouth organ is another name for the harmonica, one of our more versatile musical instruments.

The mouth as organ also serves a variety of vital purposes. And now there is help available on Cape for children who suffer from speech or feeding problems.

Pediatric speech/language pathologists at the RHCI for Children Eileen M. Ward Rehabilitation Center in Sandwich have expanded their services to help children with speech, swallowing and feeding problems.

Ironically, the need for a Children’s Swallowing and Feeding Program has increased due to other medical advances.

Cheryl Pelletier, senior speech/language pathologist with 20 years experience in the field, helped develop the specialized services to meet a growing need among her patients.

“Our population has really changed over the last 10 years,” she explains. “So many premature babies who would have died a decade ago are surviving. They’re put on feeding tubes and don’t know how to move their mouths to eat.” 

The program focuses on children with chronic gastrointestinal problems such as acid reflux, poor weight gain, growth disorders and swallowing problems.

One quarter of all normally developing children suffer a feeding or swallowing disorder. That number climbs to more than 65 percent of premature children and to 70-80 percent among children with some form of developmental delay.

Children with such conditions as cerebral palsy, cleft palate, autism, and facial or throat asymmetry also are at increased risk. The same is true for those who required treatments with tracheostomies, nasogastric feeding tubes, ventilators, stomach feeding tubes and even oxygen masks and certain medications.

 “These interventions can create problems as children learn to eat and drink, disrupting the natural progression from breast or bottle feeding to learning how to chew and safely swallow foods,” Ms. Pelletier says.

A feeding and swallowing disorder is not to be confused with picky eating habits, anorexia or bulimia. “The children we see have physical, gastrointestinal, neurological problems, food allergies or swallowing dysfunction,” Ms. Pelletier explains. “Their diets are severely restricted, and they are at risk for ‘failure to thrive.’” 

RHCI for Children has just added a monthly Feeding and Swallowing Clinic for children who would benefit from assessment and consultation with a registered dietitian as well as the feeding and swallowing team. The clinic will be offered the first Monday of the month. Also, many of these children will be evaluated by Dr. Garrett Zella, a pediatric gastroenterologist from Mass/General Hospital for Children. He sees children at the RHCI for Children monthly Gastroenterology Clinic and is another important member of the team.

The new Augmentative and Alternative Communication Program helps children who suffer from a wide variety of conditions, including “late talkers,” non-verbal communicators and those with autism, retardation, brain injury or muscular dystrophy.

“This program will meet a growing need in our community and families no longer will have to travel to Boston for help,” says Lauren Marble, a speech therapist and the program’s lead clinician.

Therapists draw from a variety of techniques to help these children, such as sign language, devices known as voice output communication aids, or VOCAS, and specialized computers and software.

“Sometimes the solution is as simple as a child pressing a button on a recorder to hear a message. In other situations, a sophisticated computer is programmed for the child’s communication needs,” Ms. Marble says.

For starters, Ms. Marble will be assessing children who can benefit from this treatment and matching them with the most appropriate technology and techniques. Looking ahead, she hopes to offer consulting services to schools and other community groups across the Cape, educating teachers and other service providers how to use alternative communications devices.

“When they’re not at home, most children are in school, and school personnel often lack training in this area,” she says.

The new services are another enhancement in pediatric rehabilitation care for the region’s children and families. Other specialized speech services include kidsSPEAK, a series of eight-week programs that provide interactive, therapeutic group experiences for children and adolescents with impaired or delayed speech and language.

For further information about specialized rehabilitation services for children, visit www.rhci.org